First efficacy and safety study of femtosecond lenticule extraction for the correction of myopia

Sekundo, Walter; Kunert, Kathleen S.; Rußmann, Christoph; Gille, Annika; Bissmann, W; Stobrawa, G.; Sticker, Markus; Bischoff, Mark; Blum, Marcus

doi:10.1016/j.jcrs.2008.05.033

Cited by 292 publications

(243 citation statements)

References 18 publications

(10 reference statements)

Supporting

Mentioning

219

Contrasting

Unclassified

Order By: Relevance

“…The laser pulse energies chosen by us are regularly used in clinical practice. [51][52][53] For the simulation, we have chosen the illumination time used in the ex vivo experiments discussed in Ref. 25.…”

Section: -Khz Repetition Rate Is Shown In the Inset Ofmentioning

confidence: 99%

Simulation of the temperature increase in human cadaver retina during direct illumination by 150-kHz femtosecond laser pulses

et al. 2011

View full text Add to dashboard Cite

Abstract.We have developed a two-dimensional computer model to predict the temperature increase of the retina during femtosecond corneal laser flap cutting. Simulating a typical clinical setting for 150-kHz iFS advanced femtosecond laser (0.8-to 1-μJ laser pulse energy and 15-s procedure time at a laser wavelength of 1053 nm), the temperature increase is 0.2• C. Calculated temperature profiles show good agreement with data obtained from ex vivo experiments using human cadaver retina. Simulation results obtained for different commercial femtosecond lasers indicate that during the laser in situ keratomileusis procedure the temperature increase of the retina is insufficient to induce damage. C 2011 Society of Photo-Optical Instrumentation Engineers (SPIE).

show abstract

Section: -Khz Repetition Rate Is Shown In the Inset Ofmentioning

confidence: 99%

Simulation of the temperature increase in human cadaver retina during direct illumination by 150-kHz femtosecond laser pulses

et al. 2011

View full text Add to dashboard Cite

show abstract

“…Although the 60 kHz FS60 Laser is the most popular laser in the clinical practice today in the US, we also simulated the temperature increase for other commercially available femtosecond laser systems: 150 kHz iFS Advanced Femtosecond Laser (at pulse energy 1 μJ); 40 kHz FEMTEC system (at pulse energy 1.4 μJ); and 200 kHz VisuMax system (at pulse energy 0.3 μJ) using the same illumination time. 31,32 These results are shown in Fig. 4.…”

Section: Resultsmentioning

confidence: 69%

Finite element model of the temperature increase in excised porcine cadaver iris during direct illumination by femtosecond laser pulses

2012

View full text Add to dashboard Cite

Abstract. In order to model the thermal effect of laser exposure of the iris during laser corneal surgery, we simulated the temperature increase in porcine cadaver iris. The simulation data for the 60 kHz FS60 Laser showed that the temperature increased up to 1.23°C and 2.45°C (at laser pulse energy 1 and 2 μJ, respectively) by the 24 second procedure time. Calculated temperature profiles show good agreement with data obtained from ex vivo experiments using porcine cadaver iris. Simulation results of different types of femtosecond lasers indicate that the Laser in situ keratomileusis procedure does not present a safety hazard to the iris.

show abstract

“…2,3,[8][9][10][11][12][13][14] In one study on 279 eyes after SMILE, 0.4 % of eyes were reported to have a loss of two or more lines. 3 By contrast, a 2.4 % risk for a two-line loss was found in 670 eyes by Hjortdal et al 6 However, in the same study, a safety index (CDVA before/CDVA after surgery) of 1.07±0.22 was found, indicating that CDVA on average increased after surgery, as would be expected because of the image magnification of myopic keratorefractive procedures.…”

Section: Safetymentioning

confidence: 99%

“…A blunt spatula is used to break any remaining tissue bridges after the laser treatment, and the lenticule is removed with a pair of forceps (see Figure 1). For further details on the surgical approach, please refer to Sekundo et al, 2 Shah et al 3 and Vestergaard et al 4 In contrast to LASIK, ReLEx is a one-laser approach, where the critical laser treatment is performed on the intact cornea rather than on exposed corneal stroma. Consequently, the potential variability associated with the excimer laser photoablation is avoided.…”

mentioning

confidence: 99%

New Developments in the Lenticule Extraction Procedure

Hjortdal¹,

Ivarsen²

2014

European Ophthalmic Review

View full text Add to dashboard Cite

31Over the last few years, surgical extraction of a refractive lenticule, or ReLEx ® , has evolved as a new treatment in the field of keratorefractive surgery. Currently, the VisuMax ® femtosecond (FS) laser (Carl Zeiss Meditec, Jena, Germany) is the only platform to offer this treatment.The 500 kHz VisuMax laser generates very fast pulses (10 -15 s range) in the near-infrared spectrum. Depending on the specific laser settings, each pulse conveys approximately 150 nJ, which causes localised photodisruption at the focal point. The generated plasma expands, creating a cavitation bubble, and, as individual cavitation bubbles fuse, the stroma is cut with a minimum of collateral damage. The VisuMax FS laser uses a high numerical aperture and a concave contact glass to focus the laser pulses with very high precision. Thus, laser spots of approximately 1 μm diameter are placed with a defined distance of 2-5 μm in a spiral pattern. To ensure centration on the visual axis, the patient fixates on a blinking light and suction is applied at the limbus to maintain stability of the eye. Initially, the posterior refractive surface of the lenticule is cut, followed by creation of the plano anterior surface, which is slightly enlarged in diameter to facilitate surgical manipulation.This review article reviews the current state of the technique, updated clinical results, 1 experimental studies and, finally, presents some of the challenges that need to be addressed by new technologies.Depending on the method used to access the lenticule, ReLEx can be split into FLEx, in which a laser-assisted in situ keratomileusis ( In contrast to LASIK, ReLEx is a one-laser approach, where the critical laser treatment is performed on the intact cornea rather than on exposed corneal stroma. Consequently, the potential variability associated with the excimer laser photoablation is avoided.In addition, the minimally invasive SMILE treatment has several theoretical advantages over flap-based treatments, including little trauma to the corneal surface, less corneal denervation and better biomechanical strength due to an almost intact anterior stroma. Since AbstractFor the last 20 years controlled excimer laser ablation of corneal tissue, either directly from the corneal stromal surface or from the corneal interior after creation of a superficial corneal flap, has become widely used to correct myopia, hyperopia and astigmatism.Recently, an intrastromal refractive procedure whereby a tissue lenticule is cut free in the corneal stroma by a femtosecond laser and removed through a small peripheral incision has been introduced. The procedure avoids creation of a corneal flap and the potential associated risks while avoiding the slow visual recovery of surface ablation procedures. The all-femtosecond-based flap-free intracorneal refractive procedure has been documented to be a predictable, efficient and safe procedure for correction of myopia and astigmatism. Technological developments related to further improved cutting quality, hyperopic and individualise...

show abstract

First efficacy and safety study of femtosecond lenticule extraction for the correction of myopia

Abstract: Preliminary results indicate that FLEx [corrected] is a promising new corneal refractive procedure to correct myopia.

Cited by 292 publications

References 18 publications

Simulation of the temperature increase in human cadaver retina during direct illumination by 150-kHz femtosecond laser pulses

Simulation of the temperature increase in human cadaver retina during direct illumination by 150-kHz femtosecond laser pulses

Finite element model of the temperature increase in excised porcine cadaver iris during direct illumination by femtosecond laser pulses

New Developments in the Lenticule Extraction Procedure

Contact Info

Product

Resources

About